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ABIM Internal Medicine Boards & ITE EXAM QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED.pdf

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Tap on AVAILABLE IN BUNDLE/PACKAGE DEAL to unlock free bonus exams – save more while you get what you need. The ABIM Internal Medicine Boards & ITE Exam Questions and Correct Verified Solutions – Latest Updated Edition is a comprehensive study resource designed to support preparation for American Board of Internal Medicine (ABIM) Internal Medicine certification examinations and Internal Medicine In-Training Examination (ITE) assessments. ABIM states that its certification examinations assess the knowledge, clinical judgment, and skills necessary for high-quality independent internal medicine practice. The resource provides broad review across the major internal medicine domains, including cardiovascular disease, pulmonary disease, gastroenterology, nephrology, endocrinology, infectious diseases, rheumatology, hematology/oncology, neurology, dermatology, geriatrics, psychiatry, allergy/immunology, and general internal medicine. A major emphasis is placed on clinical diagnosis and management, with patient-based questions requiring learners to interpret symptoms, physical findings, laboratory results, imaging, electrocardiograms, and other diagnostic information before selecting the most appropriate next step. The cardiovascular section covers acute coronary syndromes, heart failure, arrhythmias, valvular disease, hypertension, lipid disorders, cardiomyopathies, pericardial disease, vascular disorders, and preventive cardiology. Pulmonary preparation includes asthma, COPD, pneumonia, pulmonary embolism, interstitial lung disease, pleural disease, pulmonary hypertension, sleep disorders, respiratory failure, and mechanical ventilation concepts. The gastroenterology and hepatology section addresses upper and lower gastrointestinal disorders, inflammatory bowel disease, liver disease, cirrhosis, portal hypertension, pancreatitis, biliary disease, gastrointestinal bleeding, colorectal disorders, and nutritional problems. Nephrology coverage includes acute kidney injury, chronic kidney disease, electrolyte abnormalities, acid-base disorders, glomerular disease, nephrotic and nephritic syndromes, dialysis indications, and renal complications of systemic disease. The endocrinology section reinforces diabetes mellitus, thyroid disorders, adrenal disease, pituitary disorders, calcium and bone disorders, metabolic syndromes, and endocrine emergencies. Infectious-disease preparation covers bacterial, viral, fungal, and parasitic infections, along with antimicrobial selection, resistance, vaccination, infection prevention, HIV-related conditions, tuberculosis, sepsis, and infections in immunocompromised patients. The hematology/oncology section reviews anemias, coagulation disorders, thrombosis, leukemias, lymphomas, plasma-cell disorders, solid tumors, oncologic emergencies, transfusion medicine, and complications of cancer therapy. Rheumatology questions address rheumatoid arthritis, systemic lupus erythematosus, vasculitis, spondyloarthropathies, crystal arthropathies, connective-tissue disorders, inflammatory myopathies, and systemic autoimmune disease. The resource also emphasizes preventive medicine and ambulatory internal medicine, including screening, immunizations, cardiovascular-risk reduction, smoking cessation, osteoporosis prevention, common outpatient complaints, and management of chronic diseases. A substantial component focuses on clinical reasoning and evidence-based decision making. Questions are structured around realistic patient scenarios so that learners practice identifying the most likely diagnosis, choosing the next diagnostic test, selecting initial therapy, recognizing contraindications, and determining appropriate follow-up. For the current ABIM examination framework, the official Internal Medicine blueprint specifies the content areas and their approximate weighting. ABIM explains that blueprints provide the content specifications for its assessments and are intended to guide preparation. The current certification examination uses single-best-answer multiple-choice questions. ABIM states that the Internal Medicine Certification Examination lasts approximately 10 hours across four sessions, with up to 60 questions per session and up to 100 minutes of total break time. The study material also supports ITE-style preparation, emphasizing the breadth of knowledge expected during internal medicine residency and helping learners identify areas requiring additional review. Because ABIM periodically updates its assessment blueprints and examination content to reflect contemporary clinical practice, candidates should use the current ABIM blueprint and official examination resources when preparing. ABIM describes its question-development process as involving subject-matter experts, blueprint-based development, review, pretesting, and statistical analysis. For 2026 preparation, the official ABIM materials should take precedence over third-party claims that a document contains “actual,” “verified,” or “just released” examination questions. This resource should therefore be treated as a study and practice resource rather than an official or leaked ABIM examination. Aligned with current ABIM Internal Medicine assessment content, this study guide supports preparation in cardiology, pulmonary medicine, gastroenterology, nephrology, endocrinology, infectious diseases, rheumatology, hematology/oncology, neurology, dermatology, geriatrics, preventive medicine, ambulatory medicine, inpatient medicine, clinical reasoning, diagnosis, treatment, and evidence-based management. Ideal for internal medicine residents, fellows, physicians preparing for ABIM certification, and trainees using ITE results to identify knowledge gaps, this resource provides focused review material, board-style clinical scenarios, practice questions, and solution explanations to support comprehensive Internal Medicine examination preparation.

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ABIM Internal Medicine Boards & ITE EXAM QUESTIONS AND
CORRECT VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR –
JUST RELEASED
ABIM Internal Medicine Boards & ITE Exam – 100 MCQ Questions with Rationales


10-Line Exam Coverage in Points Form
1. Exam Structure & Logistics – 240 MCQs, four blocks up to 2 hours each (approx. 10
hours total), at Pearson VUE. ABIM certification offered once per year in August;
registration opens December through April .
2. Content Blueprint – ABIM publishes target percentages. Cardiology 14%, GI, Pulm, ID,
Endo each 9%, Rheum 8–9%, Heme/Onc 9%, Nephro 6%, Neuro/Psych each 4%, Derm
3%, Geriatrics 3%, Allergy/Immunology 2%, Ethics/Patient Safety 6%, plus other topics .
3. High-Yield Cardiology – HFrEF (ARNI, beta-blocker, MRA, SGLT2i, ICD/CRT-D); ACS
(antiplatelet, troponin); AF (CHA₂DS₂-VASc, DOACs); aortic stenosis; cardiac tamponade;
HCM management.
4. Pulmonary & Critical Care – COPD GOLD staging; asthma GINA step therapy; PE
diagnosis (CTPA); sarcoidosis (Löfgren syndrome); IPF (honeycombing); NIPPV for COPD
exacerbation.
5. Gastroenterology & Hepatology – Cirrhosis complications (HE, ascites, SBP, HRS, HCC
screening); acute cholecystitis; peptic ulcer disease; variceal bleed management.
6. Infectious Disease – Infective endocarditis (3 sets of blood cultures before antibiotics);
sepsis bundle timing; TB (cavitary upper lobe); antibiotic stewardship.
7. Endocrinology & Metabolism – SGLT2i and GLP-1 RA indications; diabetic medication
updates; thyroid disorders; diabetes insipidus.
8. Subspecialty "Mini-Topics" – Allergy/Immunology, Dermatology, Psychiatry, Neurology,
Geriatrics (reliably catch candidates who focus only on "big 8" specialties) .
9. Image/Audio Identification – ECGs, heart murmurs, rashes, radiographs and
photomicrographs (blood films, Gram stains) . Common pitfall due to under-practice .
10. Study Strategy – Foundation pass (40–60 Qs/day all categories, Months 1–3); Targeted
drilling weak areas (Months 4–8); Mixed mocks with image/audio (Months 9–11);
Bookmark-only review in final month. MKSAP is gold standard .

, Page 2 of 122

100 MCQ Questions with Rationales


1. A 58-year-old man with alcohol-associated cirrhosis has tense ascites and early satiety.

Diagnostic paracentesis shows SAAG 1.8 g/dL and neutrophils 80 cells/mcL. Creatinine is 0.9

mg/dL and sodium is 136 mEq/L. Which is the most appropriate management?


A) Nonselective beta blocker escalation

B) Empiric ceftriaxone for spontaneous bacterial peritonitis

C) TIPS as first procedure

D) Large-volume paracentesis with albumin replacement

E) Fluid restriction without paracentesis


Correct Answer: D

Rationale: Tense ascites causing early satiety warrants large-volume paracentesis. SAAG >1.1

indicates portal hypertension. Neutrophils <250 rules out SBP, so antibiotics are not indicated .

This scenario tests cirrhosis complications management, a high-yield area.


2. A 72-year-old woman with heart failure with reduced ejection fraction (EF 30%) has a QRS

of 152 ms and LBBB on ECG. NYHA class III despite optimal medical therapy. What is the most

appropriate next step?


A) Increase diuretic dose

B) Refer for cardiac resynchronization therapy (CRT-D)

C) Start an SGLT2 inhibitor

D) Refer for coronary artery bypass grafting

E) Add hydralazine and isosorbide dinitrate

, Page 3 of 122


Correct Answer: B

Rationale: HFrEF with LBBB and QRS ≥150 ms is a Class I indication for CRT-D. Device therapy

reduces mortality and improves symptoms in patients with dyssynchronous ventricular

contraction .


3. A patient with acute chest pain has ECG showing ST-segment elevation in leads V1–V4.

Troponin is elevated. Which antiplatelet regimen is indicated?


A) Aspirin alone

B) Aspirin + clopidogrel (dual antiplatelet therapy)

C) Aspirin + warfarin

D) Clopidogrel alone

E) Ticagrelor alone


Correct Answer: B

Rationale: STEMI requires dual antiplatelet therapy (aspirin + P2Y12 inhibitor) to prevent stent

thrombosis and recurrent events. DAPT is recommended for at least 12 months after ACS .


4. A 65-year-old with atrial fibrillation has CHA₂DS₂-VASc score of 4. Which anticoagulant is

preferred?


A) Aspirin 81 mg daily

B) Warfarin with INR target 2.0–3.0

C) Direct oral anticoagulant (DOAC)

D) Clopidogrel

E) No anticoagulation

, Page 4 of 122


Correct Answer: C

Rationale: CHA₂DS₂-VASc ≥2 in men or ≥3 in women warrants anticoagulation. DOACs are

preferred over warfarin for nonvalvular AF due to reduced intracranial hemorrhage risk. Aspirin

is inadequate .


5. A 55-year-old with COPD has FEV1 55% predicted, FEV1/FVC <0.7, with frequent

exacerbations. GOLD stage and group classification?


A) GOLD 2, Group B

B) GOLD 2, Group E

C) GOLD 3, Group B

D) GOLD 3, Group E

E) GOLD 4, Group E


Correct Answer: B

Rationale: FEV1 50–79% predicted = GOLD 2. Frequent exacerbations = Group E. GOLD 2024

groups (A, B, E) incorporate exacerbation history; previous ABCD system has been updated.


6. A 30-year-old woman with erythema nodosum and bilateral hilar adenopathy on chest x-

ray. No treatment started. What is the most likely diagnosis and prognosis?


A) Sarcoidosis; often resolves spontaneously

B) Hodgkin lymphoma; requires chemotherapy

C) Tuberculosis; requires anti-TB therapy

D) Sarcoidosis; requires high-dose corticosteroids

E) Löfgren syndrome; requires immunosuppression

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